Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes

J Athl Train. 2021 May 1;56(5):484-490. doi: 10.4085/78-20.


Context: Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce.

Objective: To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes.

Design: Cross-sectional study.

Setting: A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data.

Patients or other participants: We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools.

Main outcome measure(s): Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs.

Results: No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87).

Conclusions: Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.

Keywords: adolescent athletes; cardiovascular health; heart electric activity; sports clubs.

MeSH terms

  • Adaptation, Physiological*
  • Adolescent
  • Athletes
  • Blood Pressure / physiology*
  • Cross-Sectional Studies
  • Electrocardiography / methods*
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Rest / physiology*
  • Sports / physiology*